Individual provider Active NPI

Joe Borgman, RPH

  • Pharmacist
  • Holland, MI
National Provider Identifier
1619251212
Registry record updated Oct 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302023393 Issued in MI
Practice address
1185 Washington Ave
Holland, MI 49423-7729
Phone
(616) 392-7504
Fax
(616) 392-8021
NPI assigned
Oct 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302023393 MI Primary
Geriatric Pharmacist 1835G0303X 5302023393 MI

Addresses

Primary practice location

1185 Washington Ave
Holland, MI 49423-7729

Mailing address

1185 Washington Ave
Holland, MI 49423-7729
Phone (616) 392-7504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302023393MIMDGeriatric Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Fare, LLC Past Accepting new patients
Family Fare, LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317427200000",
    "number": "1619251212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 WASHINGTON AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237729",
            "telephone_number": "616-392-7504",
            "fax_number": "616-392-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 WASHINGTON AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237729",
            "telephone_number": "616-392-7504",
            "fax_number": "616-392-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGMAN",
        "first_name": "JOE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-01",
        "last_updated": "2011-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302023393",
            "primary": true
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "MI",
            "license": "5302023393",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.